Skip to main content
SpringerLink
Log in
Book cover

Der Magen pp 193–210Cite as

Zelluläre Heilungsmechanismen beim Magenulkus

  • Conference paper

  • 25 Accesses

Zusammenfassung

Ein Ulkus ist eine tiefe nekrotische Läsion der gastroduodenalen Mukosa, welche durch die Muscularis mucosae in die Submukosa penetriert (Abb. 1) [1]. Ein Ulkus entwickelt sich als Ergebnis eines ausgeprägten Ungleichgewichtes zwischen aggressiven Faktoren (wie z.B. HC1, Pepsin, Lysolecithin, Äthanol, nicht-steroidalen Antiphlogistika, H. pylori, Infektionen etc.), die im Magenoder Duodenallumen vorhanden sind, und den Abwehrmechanismen der Schleimhaut (s. Tabelle 1) [2–4]. Zahlreiche Faktoren wie genetische, neurale, humorale und iatrogene (z.B. nicht-steroidale Antiphlogistika) wurden als kausale Faktoren bei der Entstehung gastroduodenaler Ulzerationen diskutiert [2–4].

Darstellung eines 5 Tage alten Magenulkus der Ratte nach Applikation von Essigsäure auf die Serosa [7]. HZ, Heilungszone im Ulkusrandbereich. GT, Granulationsgewebe im Ulkusgrund. [Nach [7])

This is a preview of subscription content, log in via an institution.

Chapter
USD   29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD   44.99
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD   59.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Learn about institutional subscriptions

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

Literatur

  1. Robbins SL, Cotran RS, Kumar V (eds.) Healing and repair in robbins pathologic basis of disease. Saunders, Philadelphia, pp 71–86

    Google Scholar 

  2. Richardson CT (1985) Pathogenetic factors in peptic ulcer disease. Am J Med 79 (2C): 1–7

    Article  PubMed  CAS  Google Scholar 

  3. Isenberg JI (1981) Peptic ulcer. Dis Mon Dec: 1–58

    Google Scholar 

  4. Lam SK (1984) Pathogenesis and pathophysiology of duodenal ulcer. Clin Gastroenterol 13: 447–472

    PubMed  CAS  Google Scholar 

  5. Virchow R (1853) Historisches, Kritisches and Positives zur Lehre der Unterleibesaffektionen. Virchow Arch Pathol Anat Physiol 5: 281–386, 632

    Google Scholar 

  6. Piasecki C (1992) Evidence for an infarctive pathogenesis of acute and chronic gastroduodenal ulceration. J Physiol and Pharmacol 43: 99–112

    CAS  Google Scholar 

  7. Tarnawski A, Hollander D, Stachura J, Krause WJ, Eltorai M, Dabros W, Gergely H (1990) Vascular and microvascular changes — key factors in the development of acetic acid-induced gastric ulcers in rats. J Clin Gastroenterol 12 (Suppl 1): S148–157

    Article  PubMed  Google Scholar 

  8. Okabe S, Roth JLA, Pfeiffer CJ (1971) A method for experimental, penetrating gastric and duodenal ulcers in rats. Dig Dis 16: 277–284

    Article  CAS  Google Scholar 

  9. Halter F, Barbezat GO, Van Hoorn-Hickman R, Van Hoorn WA (1980) Healing dynamics of traumatic gastric mucosal defects in the normal and hyperacid stomach. Dig Dis Sci 25: 916–920

    Article  PubMed  CAS  Google Scholar 

  10. Blom H (1983) Cimetidine and parietal cell regeneration in experimental wounds in rat gastric mucosa. A light and electron microscopic study. Scand J Gastroenterol 18: 853–857

    Article  PubMed  CAS  Google Scholar 

  11. Helpap B, Hattori T, Gedigk P (1981) Repair of gastric ulcer. A cell kinetic study. Virchows Arch [A] 392: 159–170

    Google Scholar 

  12. Helander HE (1983) Morphologic studies on the margin of gastric corpus wounds in the rat. J Submicrosc Cytol 15 (3): 627–643

    PubMed  CAS  Google Scholar 

  13. Geboes K, Rutgeerts P, Vantrappen G, Desmet V (1984) The influence of 15(R)-15 methyl PGE2, methyl ester, on Nd: YAG laser-induced gastric ulcers. Gastrointestinal Endoscopy 30: 173–178

    Google Scholar 

  14. Inauen W, Wyss PA, Kayser S, Baumgartner A, Schurer-Maly CC, Koelz HR, Halter F (1988) Influence of prostaglandins, omeprazole, and indomethacin on healing of experimental gastric ulcers in the rat. Gastroenterology 95: 636–641

    PubMed  CAS  Google Scholar 

  15. Hunt TK (1991) The principles of wound healing. In: Halter F, Garner A, Tytgat GNT (eds) Mechanisms of peptic ulcer healing. Falk Symposium No 59. Kluwer, Dordrecht, pp 1–12

    Google Scholar 

  16. Freston JW (1990) Overview of medical therapy of peptic ulcer disease. Gastroent Clin North Am 9 (1): 121–140

    Google Scholar 

  17. Shorrock CJ, Rees WDW (1989) Bicarbonate secretion and alkaline microclimate. In: Hollander D, Tarnawski A, Gastric cytoprotection. Plenum, New York, pp 91–108

    Google Scholar 

  18. Allen A, Hunter AC, Mall A (1989) Mucus secretion. In: Hollander D, Tarnawski A, (eds) Gastric Cytoprotection. Plenum, New York, pp 75–90

    Chapter  Google Scholar 

  19. Bravo R, Frank R, Blundell PA, MacDonald-Bravo H (1987) Cyclin/PCNA is the auxiliary protein of DNA polymerase delta. Nature 326: 515–517

    Article  PubMed  CAS  Google Scholar 

  20. Burgess AW (1989) Epidermal growth factor and transforming growth factor. Br Med Bull 45: 401–424

    PubMed  CAS  Google Scholar 

  21. Lee H, Hansson H-A, Norstrom E, Hellander HF (1991) Immunoreactivities for epidermal growth factor ( EGF) and for EGF receptors in rats with gastric ulcer. Cell Tissue Res 265: 211–218

    Google Scholar 

  22. Tarnawski A, Stachura J, Durbin T, Sarferh IJ, Gergely H (1992) Increased expression of epidermal growth factor receptor during gastric ulcer healing in rats. Gastroenterology 102: 695–698

    PubMed  CAS  Google Scholar 

  23. Skov Olsen P, Poulsen SS, Therkelsen K, Nexo E (1986) Effect of sialoadenectomy and synthetic human urogastrone on healing of chronic gastric ulcers in rats. Gut 27: 1443–1449

    Article  Google Scholar 

  24. Konturek SJ (1990) Role of growth factors in gastroduodenal protection and healing of peptic ulcers. Gastroenterol Clin N Am 19: 41–65

    CAS  Google Scholar 

  25. Wright NA, Pike C, Elia G (1990) Induction of a novel epidermal growth factor—secreting cell lineage by mucosal ulceration in human gastrointestinal stem cells. Nature 343: 82–85

    Article  PubMed  CAS  Google Scholar 

  26. Konturek SJ, Brzozowski T, Majka J, Dembinski A, Slomiany A, Slomiany BL (1992) Transforming growth factor alpha and epidermal growth factor in protection and healing of gastric mucosal injury. Scand J Gastroenterol 27: 649–655

    Article  PubMed  CAS  Google Scholar 

  27. Tarnawski A, Hollander D, Stachura J, Gergely H, Krause WJ, Sarfeh IJ. Role of angiogenesis in healing of experimental “gastric ulcer”. In: Halter F, Garner A, Tytgat GNJ, (eds) Mechanisms of Peptic Ulcer Healing. Falk Symposium 59. Kluwer, Dordrecht, pp 165–171

    Google Scholar 

  28. Folkman J, Szabo S, Stovroff A, McNeil P, Li W, Shing Y (1991) Duodenal ulcer. Discovery of a new mechanism and development of angiogenic therapy that accelerates healing. Ann Surg 214: 414–427

    Google Scholar 

  29. Leibovich SJ, Polverini PJ, Shepard HM, Wiseman DM, Shively V, Nuseir N (1987) Macrophage-induced angiogenesis is mediated by tumous necrosis factor-a. Nature 329: 630–632

    Article  PubMed  CAS  Google Scholar 

  30. Klagsburn M (1988) Angiogenesis factors. In: Ryan US (ed) Endothelial cells, vol II. CRC Press, Boca Raton, pp 37–50

    Google Scholar 

  31. D’Amore PA, Braunhut SJ (1988) Stimulatory and inhibitory factors in vascular growth control. In: Ryan US (ed) Endothelial cells, vol II. CRC Press, Boca Raton, pp 13–36

    Google Scholar 

  32. Tarnawski A, Hollander D, Stachura J, Sarfeh IJ, Gergely H, Krause WJ (1989) Angiogenic response of gastric mucosa to ethanol injury is abolished by indomethacin. Gastroenterology 96: A505

    Google Scholar 

  33. Tarnawski A, Hollander D, Stachura J, Sheffield M, Gergely H, Krause WJ (1990) Angiogenic response of damaged gastric mucosa —a prostaglandin mediated process? Gastroenterology 98: A136

    Google Scholar 

  34. Tarnawski A, Stachura J, Douglass TG, Krause WJ Gergely H, Sarfeh IJ (1991) Indomethacin impairs quality of experimental gastric ulcer healing: a quality histologic and ultrastructural analysis. In Graner A, O’Brien P (eds) Mechanisms of injury, protection and repair of the upper gastrointestinal tract. Wiley, London, pp 521–531

    Google Scholar 

  35. Tarnawski A, Stachura J, Krause WJ, Douglass TG, Gergely H (1991) Quality of gastric ulcer healing-a new, emerging concept. J Clin Gastroenterol 13 (Suppl 1): S45–47

    Google Scholar 

  36. Ogihara Y, Okabe S (1991) Effects of ornoprostil on the healing of acetic acid-induced gastric ulcer in rats. In: Halter F, Garner A, Tytgat GNJ (eds) Mechanisms of Peptic Ulcer Healing. Falk Symposium 59. Kluwer, Dordrecht, pp 151–163

    Google Scholar 

  37. Martin GR, Timpl R (1987) Laminin and other basement membrane components. Annu Rev Cell Biol 3: 57–85

    Article  PubMed  CAS  Google Scholar 

  38. Ruoslahti E, Pierschbacher MD (1987) New perspectives in cell adhesion: RGF and integrins. Science 238: 491–497

    Google Scholar 

  39. Clark RAF, Della Pelle P, Manseau E, Lanigan JM, Dvorak HF, Colvin RB (1982) Blood vessel fibronectin increases in conjunction with endothelial cell proliferation and capillary in growth during wound healing. J Invest Dermatol 79: 269–276

    Article  PubMed  CAS  Google Scholar 

  40. Couchman JR, Austria MR, Woods A (1990) Fibronectin-cell interactions. J Invest Dermatol 94 (Suppl 6): S7 — S14

    Article  Google Scholar 

  41. Brotchie H, Wakefield D (1991) Fibronectin: structure, function and significance in wound healing. Australasian J Dermato 31 (1): 47–56

    Article  Google Scholar 

  42. Luomanen M, Virtanen I (1991) Fibronectins in healing incision, excision and laser wounds. J Oral Pathology Med 29 (3): 133–138

    Article  Google Scholar 

  43. Martinez-Hernandez A, Delgado FM, Amenta PS (1991) The extracellular matrix in hepatic regeneration. Localization of collagen types I, III, IV, laminin, and fibronectin. Lab Investig 64 (2): 157–166

    PubMed  CAS  Google Scholar 

  44. Humphries MJ, Obara M, Olden K, Yamada KM (1989) Role of fibronectin in adhesion, migration, and metastasis. Cancer INvest 7 (4): 373–393

    Article  PubMed  CAS  Google Scholar 

  45. Colvin RB (1989) Fibronectin in wound healing. In: Mosher DF (ed) Fibronectin. Academic, San Diego, pp 213–254

    Chapter  Google Scholar 

  46. Kim KS, Oh JS, Kim IS, Jo JS (1990) Topical fibronectin treatment in persistent corneal epithelial defects and corneal ulcers. Korean J Ophthalmol 4 (1): 5–11

    PubMed  CAS  Google Scholar 

  47. Lu S-Y, Tarnawski A, Stachura J, Thillai I (1992) Sequential expression and distribution of fibronectin, laminin and collagen III and IV during experimental gastric ulcer healing. Gastroenterology A116: 192

    Google Scholar 

  48. Tarnawski K, Hollander D, Krause WJ, Dabros W, Stachura J, Gergely H (1990) “Healed” experimental gastric ulcers remain histologically and ultrastructurally abnormal. J Clin Gastroenterol 12(Suppl 1): S139–147

    Google Scholar 

  49. Tarnawski A, Erickson RA (1991) Sucralfate-24 years later: current concepts on its protective and Therapeutic actions. Europ J Gastroenterol Hepatol 3: 795–810

    Google Scholar 

  50. Tarnawski A, Krause WJ, Gergely H, Stachura J, Douglass TG, Maalox 70 accelerates healing and reverses deleterious effect of indomethacin on healing of experimental gastric ulcer. World Congress of Gastroenterology, Sydney, Australia Aug 26–31,1990 (Abstr.)

    Google Scholar 

  51. Tarnawski A, Stachura J, Mach T, Krause WJ, Gergely H (1991) Is the quality of experimental gastric ulcer healing influenced by ranitidine or omeprazole? Histologic and ultastructural assessment. Gastroenterology A 1 73: 100

    Google Scholar 

  52. Tarnawski A, Erickson RA (1991) Sucralfate-24 years later: current concepts on its protective and therapeutic actions. Europ J Gastroenterol Hepatol 3: 795–810

    Google Scholar 

Download references

Authors
  1. A. Tarnawski
    View author publications

    You can also search for this author in PubMed Google Scholar

Editor information

Editors and Affiliations

  1. Medizinischen Klinik und Poliklinik B, Universität Münster, Albert-Schweitzer-Straße 33, D-48149, Münster, Deutschland

    W. Domschke FACG (Direktor) (Direktor)

  2. Instituts für Physiologie, Universität Kraków, Grzegórzecka 16, PL-31531, Kraków, Polen

    S. J. Konturek (Direktor) (Direktor)

Rights and permissions

Reprints and permissions

Copyright information

© 1993 Springer-Verlag Berlin Heidelberg

About this paper

Cite this paper

Tarnawski, A. (1993). Zelluläre Heilungsmechanismen beim Magenulkus. In: Domschke, W., Konturek, S.J. (eds) Der Magen. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-662-06526-6_12

Download citation

  • DOI: https://doi.org/10.1007/978-3-662-06526-6_12

  • Publisher Name: Springer, Berlin, Heidelberg

  • Print ISBN: 978-3-540-56612-0

  • Online ISBN: 978-3-662-06526-6

  • eBook Packages: Springer Book Archive

Publish with us

Policies and ethics

Search

Navigation